Claims Generalist/MedPlus Health
Insurance · Murfreesboro
MEDPlus was founded on the idea of creating a customer service centric, technology driven, workers’ compensation claims processing organization. We understand claims adjusters, self-Insured companies and other organizations need a service company that saves time and money, which is also easy to work with.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
The Claims Generalist is responsible for actively coordinating MEDPlus Health Solutions referrals. He/she is responsible for maintaining accurate, detailed, and timely records daily. The Claims Generalist assures excellent communication with claimants, providers, and clients, and ensures a consistent, quality experience in every interaction. The Claims Generalist is a team player that is willing to participate in the growth of MEDPlus Health Solutions LLC. and able to assist where needed.
· Receive claim information from clients and effectively communicate claimant status with clients.
· Maintain claimant information in CRM and TCM billing system
· Receive calls from claimants and effectively communicate the status of claims and how the claims process works.
· Process orders from claimants and ensure orders are entered into CRM and TCM billing system.
· Ensure proper invoicing to customers by referencing CRM software and TCM
· Effectively communicate with co-workers on status, assistance and any helpful information needed.
· Shipping supplies to workman’s comp claimants
· Obtaining purchase orders from appropriate DME for supply orders
· Input and send purchase orders to billing department in a timely manner
· Send invoices to billing departments
· Answer phones and direct calls to appropriate party
· Accept deliveries from USPS, UPS, and FedEx and distribute accordingly
· Candidates should have at least 1-2 years' of experience in a claims processing environment (preferably healthcare-oriented);
· Billing background is a huge plus;
· Ability to handle a high volume of calls and emails daily, ability to multitask, and work effectively and quickly with a software system.
· Customer service skills are a must;
· Ability to pivot and change direction multiple times a day when necessary;
· Self-motivated, dependable, organized; Ability to perform assignments and tasks accurately and within prescribed timeframes, as well as against broad business objectives, with little or no intervention; Follow MEDPlus Health Solutions Policies and Procedures;
· Team oriented; Ability to work with: peers, subordinates, clients, vendors, and executives; Share knowledge and skills with others; actively contributes in meetings; Demonstrate MEDPlus Health Solutions values, specifically integrity and respect of all people.
· Identify, analyze, and evaluate fundamental problems in a complex environment
· Exercise highly seasoned judgment and patience in establishing approaches for ensuring resolutions;
· Develop and recommend strategy in a timely manner;
· Demonstrate the ability to balance individual dignity, client needs, and fiscal responsibility for MEDPlus Health Solutions
· Educational requirement: High School diploma or equivalent.
Job Type: Full-time
Pay: $16.00 - $18.00 per hour
We offer competitive salaries, generous benefits packages (health, dental, vision insurance; 401k with company match), and lots of career development opportunities—we love promoting from within!